You don’t have to be a dentist to screen for caries, according to the University of Manitoba Dr. Gerald Niznick College of Dentistry, where researchers have developed a method that allows non-oral health professionals to assess the risk of tooth decay in children under the age of 6.
“Poor oral health and early childhood caries in children is a huge issue,” said Bob Schroth, DMD, MSc, PhD, a professor in the school’s Department of Preventive Dental Science and creator of the Canadian Caries Risk Assessment Tool.
“It’s epidemic in some populations. I think this tool is one way we can raise awareness and get people thinking about teeth and young kids,” said Schroth, who also is a professor in the Max Rady College of Medicine’s departments of Community Health Sciences and Pediatrics and Child Health as well as a scientist with the Children’s Hospital Research Institute of Manitoba.
The tool was developed for doctors, daycare workers, dieticians, and social workers to help identify whether a child under the age of 6 is at risk of tooth decay. It also can be used by dentists who might not have many children patients, said Schroth.
Available in English and French, the tool comprises questions focused on the factors that cause cavities. The professional will ask the child’s parents these questions, which include whether the child’s teeth are cleaned at least twice a day and if the child eats sugary snacks and drinks between meals.
Points are given for each yes and no question. The total determines a high or low caries risk status. If the risk is high, the professional is urged to refer the child to a dentist for treatment and apply fluoride varnish. There also are recommendations the professional can give to the parents.
The tool includes a series of photographs to give the professional an idea of what early and advanced cavities look like or if there is plaque present as well.
“I think traditionally, a lot of people think, ‘Well, baby teeth fall out eventually, so why do we need to worry about them?’ But we know that good early childhood oral health sets that good foundation for a lifetime of good dental health,” said Schroth.
In 2017, the Public Health Agency of Canada’s Office of the Chief Dental Officer approached Schroth to develop the tool because of his research background and his work with the Healthy Smile Happy Child initiative, which has been promoting early childhood oral health in Manitoba for the past 20 years.
Schroth and his team began with a literature review to see what the main risk factors are over time for kids getting cavities. Then, they developed a draft of the tool and introduced it to a focus group of nearly 70 people including doctors, nurses, nurse practitioners, dieticians, and dental professionals. The group provided feedback, and the tool was revised.
While Schroth is currently conducting a small validation pilot study funded by the Network for Canadian Oral Health Research, the next step is to secure funding for a more robust analysis.
The tool has been endorsed by the Canadian Paediatric Society, the Canadian Academy of Pediatric Dentistry, the Canadian Association of Public Health Dentistry, and the Public Health Agency of Canada. A link to the tool now is included as part of the Rourke Baby Record, a guide for primary healthcare practitioners of children.
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